Why are MDAs becoming such an area of interest?
There are a number of factors that are changing the current environment and increasing interest in MDAs.
The decrease in funding from USAID and other donors in many countries is creating a funding gap while demand for reproductive health services continues to grow. UNFPA (United Nations Fund for Population Activities), a long-term supplier of contraceptives, has regular annual budget fluctuations that can disrupt supplies. Similarly, lack of predictability at national level results from funding fluctuations, weak policies and systems of donors, governments and implementers, and particularly lack of co-ordination between these actors.
For more on this, see:
- Supplies Initiative website
- Access to condoms and HIV/AIDS information: a global health and human rights concern
- Reproductive health commodity security (RHCS) country case study synthesis, a four country study commissioned by DFID and the Netherlands Ministry of Foreign Affairs.
Donors are increasingly focused on sustainability. Some view the 2005 Paris Declaration on Aid Effectiveness as a mandate to shift control more to local governments who will need a range of options for ensuring contraceptive security. Some donors are looking for ways to co-finance programmes and make them more cost-effective.
Meanwhile, the global market is expanding. More suppliers in developing countries have emerged as national players with potential to gain a foothold in international markets as intellectual property and technology barriers decline with some of the older contraceptives. With the expansion of markets, donors are gradually untying aid to their home-country manufacturers in search of more cost-effective supplies.
New donors and implementers with a potentially more market-oriented view on solutions are increasingly involved in reproductive health supply issues. MDAs can respond to these circumstances by addressing sustainability, access and choice through greater involvement of the commercial sector.
